 |
|
One-Year Health Care Costs Associated With Delirium in the Elderly Population
Douglas L. Leslie, PhD;
Edward R. Marcantonio, MD, MSc;
Ying Zhang, MD, MPH;
Linda Leo-Summers, MPH;
Sharon K. Inouye, MD, MPH
Arch Intern Med. 2008;168(1):27-32.
Background While delirium has been increasingly recognized as a serious and potentially preventable condition, its long-term implications are not well understood. This study determined the total 1-year health care costs associated with delirium.
Methods Hospitalized patients aged 70 years and older who participated in a previous controlled clinical trial of a delirium prevention intervention at an academic medical center between 1995 and 1998 were followed up for 1 year after discharge. Total inflation-adjusted health care costs, calculated as either reimbursed amounts or hospital charges converted to costs, were computed by means of data from Medicare administrative files, hospital billing records, and the Connecticut Long-term Care Registry. Regression models were used to determine costs associated with delirium after adjusting for patient sociodemographic and clinical characteristics.
Results During the index hospitalization, 109 patients (13.0%) developed delirium while 732 did not. Patients with delirium had significantly higher unadjusted health care costs and survived fewer days. After adjusting for pertinent demographic and clinical characteristics, average costs per day survived among patients with delirium were more than 2 times the costs among patients without delirium. Total cost estimates attributable to delirium ranged from $16 303 to $64 421 per patient, implying that the national burden of delirium on the health care system ranges from $38 billion to $152 billion each year.
Conclusions The economic impact of delirium is substantial, rivaling the health care costs of falls and diabetes mellitus. These results highlight the need for increased efforts to mitigate this clinically significant and costly disorder.
Author Affiliations: Department of Health Administration and Policy, Medical University of South Carolina, Charleston (Dr Leslie); Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School (Drs Marcantonio and Inouye), and Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife (Drs Zhang and Inouye), Boston, Massachusetts; and Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut (Ms Leo-Summers).
 CiteULike  Connotea  Delicious  Digg  Facebook  Reddit  Technorati  Twitter
What's this?
RELATED LETTER
Delirium and Costs of Informal Home Care
Giuseppe Bellelli, Angelo Bianchetti, and Marco Trabucchi
Arch Intern Med. 2008;168(15):1717.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Delirium Assessment and Management
Crit Care Nurse 2012;32:79-82.
FULL TEXT
Interventions to Improve Recognition of Delirium: A Sine Qua Non for Successful Transitional Care Programs
Alici
Arch Intern Med 2012;172:80-80.
FULL TEXT
Delirium superimposed on dementia is pervasive and associated with restraint use among older adults residing in long-term care
Fick
Evid. Based Nurs. 2011;0:ebnurs-2011-100292v1-ebnurs-2011-100292.
FULL TEXT
Anticipating and managing postoperative delirium and cognitive decline in adults
Sanders et al.
BMJ 2011;343:d4331-d4331.
FULL TEXT
Diagnosis, Prevention, and Management of Delirium in the ICU
Hessler and Josephson
ICU Director 2011;2:122-127.
ABSTRACT
Review: Delirium in the Elderly: A Comprehensive Review
Mittal et al.
AM J ALZHEIMERS DIS OTHER DEMEN 2011;26:97-109.
ABSTRACT
Which medications to avoid in people at risk of delirium: a systematic review
Clegg and Young
Age Ageing 2011;40:23-29.
ABSTRACT
| FULL TEXT
Depression, Anxiety Disorders and Type D Personality as Risk Factors for Delirium After Cardiac Surgery
Tully et al.
Aust N Z J Psychiatry 2010;44:1005-1011.
ABSTRACT
| FULL TEXT
Predictive Model for Postoperative Delirium in Cardiac Surgical Patients
Afonso et al.
SEMIN CARDIOTHORAC VASC ANESTH 2010;14:212-217.
ABSTRACT
Predicting the onset of delirium in the post-operative patient
Noimark
Age Ageing 2009;38:368-373.
ABSTRACT
| FULL TEXT
Predisposing Factors Associated With Delirium Among Demented Long-Term Care Residents
Voyer et al.
Clin Nurs Res 2009;18:153-171.
ABSTRACT
Delirium and Costs of Informal Home Care
Bellelli et al.
Arch Intern Med 2008;168:1717-1717.
FULL TEXT
|
